Which nonsurgical procedures are used in the treatment of internal hemorrhoids?

Updated: Sep 24, 2019
  • Author: Kyle R Perry, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Numerous nonoperative methods to destroy internal hemorrhoids are available. Nonsurgical techniques function by rubber band ligation, ablation, sclerosis, or necrosis of mucosal tissues. [32, 33, 34] Despite several meta-analyses and considerable personal preference, there is no clear advantage of one technique over the others; however, all should be the first-line treatment of all first- and second-degree internal hemorrhoids that do not respond to conservative therapy. All nonoperative treatments have approximately similar efficacy when administered by an experienced clinician.

Lord dilatation, in which the anal canal is manually stretched under anesthesia, is seldom used in the United States, and many colorectal surgeons condemn its use, because it is essentially an uncontrolled disruption of the sphincter mechanism.


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